Currently, there is a global pandemic of diabetes mellitus with an estimated 220 million sufferers worldwide; 3 million of which are presently in the United Kingdom. Worst still, there are close to 1 million yet-to-be-diagnosed cases in the United Kingdom alone, and many more worldwide. Type 2 diabetes constitutes about 95% of all cases of diabetes. As the incidence of the disease increases, so does the cost of its treatment. In the United Kingdom, the cost of diabetes treatment and management of complications arising from the disease accounts for about 10% of the National Health Service (NHS) budget (GBP 9.8 billion). This cost is likely to rise to an estimated GBP 16.9 billion by 2035. Several factors have contributed to the epidemic nature of the disease. These include increased sedentary lifestyle, population growth, and increased incidence of obesity. Defective insulin secretion and action, resulting in elevated plasma glucose, represent major metabolic derangements that characterize type 2 diabetes. Unfortunately, there is no cure yet for the disease, nor is there any therapeutic agent that can reinstate normal glucose metabolism in people suffering from diabetes. Most of the clinically available anti-diabetic drugs have inefficiencies, such as obvious side effects and short half-life. Further, although there are currently several drugs for the treatment of diabetes, none of these therapeutic options has adequately addressed unmet needs in non-insulin treatment of the disease, and there is clearly an unmet need for novel therapeutics agents.
Oral anti-diabetic medications currently used in the treatment of type 2 diabetes include biguanides (such as metformin), sulphonylureas (such as tolbutamide, acetohexamide, tolazamide, chlorpropamide, glipizide, glibenclamide, glimepiride, gliclazide, glycopyramide, and gliquidone), thiazolidinediones (such as rosiglitazone, pioglitazone, and trogiitazone), meglitinides (such as repaglinide and nateglinide) alpha-glucosidase inhibitors (such as miglitol, acarbose, and voglibose) and dipeptidyl peptidase-4 inhibitors (such as vildagliptian, sitagliptian, saxagliptian, linagliptin, allogliptin, and septagliptin). However, for many patients, these oral medications, both in isolation and in combination with one another, are unable to control metabolic derangements that characterize type 2 diabetes. In advanced cases, the use of injectable medication is required (in combination with the oral medication). The above problems associated with type 2 diabetes mean there is an urgent need for alternative treatments for this condition.